Padcev

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vic120

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anyone know how its covered, I tried to look it up on medicare.gov nothing shows,But when I look online it kind of looks like part D should cover but not conclusive benouf for confidence
 
vic120 said:
anyone know how its covered, I tried to look it up on medicare.gov nothing shows,But when I look online it kind of looks like part D should cover but not conclusive benouf for confidence
Click to expand...

Padcev contains the active ingredient enfortumab vedotin-ejfv. This ingredient is an antibody-drug conjugate (ADC), meaning it consists of an antibody* that’s linked to an active drug. Padcev’s antibody carries the active chemotherapy drug. And the chemotherapy drug works to destroy urothelial cancer cells.

Padcev comes as a powder that’s mixed with water to form a solution. The solution is given by your healthcare professional as an intravenous (IV) infusion. An IV infusion means that the drug is injected into your vein, typically in your arm, over a period of time.
[EXTERNAL LINK] - Padcev: Side effects, cancer treatment, cost, dosage, and more

Seems to be Part B, infusion therapy

https://www.modahealth.com/pdfs/med_criteria/Padcev.pdf
 
somarco said:
Padcev comes as a powder that’s mixed with water to form a solution. The solution is given by your healthcare professional as an intravenous (IV) infusion.
Click to expand...
Just ran it by my son. He said that Phoebe doesn't even stock it yet. So probably more than the usual $10 thousand a pop.
 
somarco said:
Padcev contains the active ingredient enfortumab vedotin-ejfv. This ingredient is an antibody-drug conjugate (ADC), meaning it consists of an antibody* that’s linked to an active drug. Padcev’s antibody carries the active chemotherapy drug. And the chemotherapy drug works to destroy urothelial cancer cells.

Padcev comes as a powder that’s mixed with water to form a solution. The solution is given by your healthcare professional as an intravenous (IV) infusion. An IV infusion means that the drug is injected into your vein, typically in your arm, over a period of time.
[EXTERNAL LINK] - Padcev: Side effects, cancer treatment, cost, dosage, and more

Seems to be Part B, infusion therapy

https://www.modahealth.com/pdfs/med_criteria/Padcev.pdf
Click to expand...


I've actually confirmed with the doctor that this is not a part B but a D drug but I cant get it to show on med.gov
 
vic120 said:
I've actually confirmed with the doctor that this is not a part B but a D drug but I cant get it to show on med.gov
Click to expand...

Could be, but it also could be that the doc doesn't want to fool with it as a Part B. Quite a few docs no longer administer Part B drugs in office because they are limited on how much they can mark up the drug and make little to nothing for stocking and administering the drug. Instead, they refer the patient to an infusion center for treatment.

@kgmom219 can offer more insight into this. Where is the patient located? City & state. Look for infusion centers in that area, contact them and find out if they can/will get the drug.


The AARP PDP's show Padcev as tier 5 $3200 for the initial dose. All other plans show it as not covered, so full price for every refill.
 
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somarco said:
Could be, but it also could be that the doc doesn't want to fool with it as a Part B. Quite a few docs no longer administer Part B drugs in office because they are limited on how much they can mark up the drug and make little to nothing for stocking and administering the drug. Instead, they refer the patient to an infusion center for treatment.

@kgmom219 can offer more insight into this. Where is the patient located? City & state. Look for infusion centers in that area, contact them and find out if they can/will get the drug.


The AARP PDP's show Padcev as tier 5 $3200 for the initial dose. All other plans show it as not covered, so full price for every refill.
Click to expand...


No no this doc does, I have had her run B on other meds I have worked with her many times,

this is a D med she says SS has been covering it

I just got word on that
 
vic120 said:
anyone know how its covered, I tried to look it up on medicare.gov nothing shows,But when I look online it kind of looks like part D should cover but not conclusive benouf for confidence
Click to expand...

Florida Blue regional PPO has it listed as tier 5 PA. Didn't check the other plans
 
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